Coffey Break


  Forward to a friend February 2017 Vol 16, Issue 2

In This Issue

Adult Day News (GADSA)

Activity Professionals (GAAP)
LeadingAge Georgia Business Connection
Center For Positive Aging
Culture Change News
Georgia Institute on Aging
General Notes of Interest
LeadingAge (National)
News Throughout the Spectrum of Aging Services
Public Policy
Vacancy Report

Quick Links

Upcoming Events Calendar
Job Mart


Special Thanks to Our Institute Partners

Institute Supporters

Inside Your Association - LeadingAge Georgia

LeadingAge Georgia is the statewide association of over 150 key not-for-profit and other mission-focused organizations dedicated to providing quality housing, health care, community-based and other related services for older Georgians. The mission of LeadingAge Georgia is to represent and promote the common interests of its members through leadership, advocacy, education and other services in order to enhance each member's ability to serve older Georgians.





Calling ALL Members: 2017 Workforce Summit | REGISTER TODAY One of the two focus areas for LeadingAge Georgia for the next few years is Recruiting & Retaining Competent Staff. There is a lot of significant information to consider when positioning your organization to be the work place of the future. Information you need to know will be presented and discussed with your colleagues to make sure you are intentional in our planning.

This summit is for leaders in all positions in LeadingAge Georgia member organizations, especially senior management and even board members. Robyn Stone has facilitated workforce summits in several other states and will be with us February 16th.


Information throughout the day will include:
Our role of creating economic prosperity in an aging society; Positioning and leveraging your Organization to move from an accidental to a valued occupation; Reframing the Eldercare workforce to a valued occupation; The reality of the workplace and what can you control; Facing Recruitment and Retention Challenges; Job Quality - How to draw in staff & What Pushes them away; How to nurture and prepare staff to advance in your organization & not lose them to the competition.


Who should attend?
Staff at all levels, especially senior management and board members.






Georgia Governor asks First Lady Sandra Deal and DHS Commissioner Crittenden to Convene State of Georgia Older Adults Cabinet

LeadingAge Georgia President & CEO, Walter Coffey, was invited to join fellow policymakers, leaders in state agencies and other stakeholders as a member of the cabinet. LeadingAge Georgia board member, Eve Anthony, ED at Athens Community Council on Aging, was also invited to participate. The first meeting was held the end of January at the Governor's mansion. The purpose is to provide a place for stakeholders to come together to strategically develop a plan focused on improving the wellbeing of Georgia's aging population. The cabinet will examine, study and access the current issues impacting older Georgians such as: healthcare, nutrition, transportation, housing, safety, abuse, neglect and exploitation, aging services, workforce development and economic security. There was a lot of energy and common thinking at the first meeting. Cabinet members, many of whom have worked together for years, were immediately on the same page. We look forward to the second meeting in March.



2017 Annual Conference: The Power of Purpose



Message from the Chair:


Join us and your peers for this inspiring gathering of leaders to look at aging from a new perspective. Over 30 sessions to choose from as well as a Solutions Center Expo. It's up to us to be the voice for change that makes lives better today and in the future.

-Mark Lowell, St. George Village, Chair of LeadingAge Georgia Board



2017 Conference on Aging Keynote Speakers

David Ault is an internationally known author and celebrated metaphysical teacher and speaker. He is an ordained minister through Centers for Spiritual Living and currently serves as the Senior Minister of Spiritual Living Center of Atlanta in Atlanta, Georgia. His weekly messages are heard and viewed by thousands across the world. Since his spiritual reawakening in the mid 1980s, Ault has traveled the globe offering his gifts as a singer/songwriter, speaker, and facilitator.

David has established a thriving non-government regulated school in Siem Reap, Cambodia, which provides free education, medical/hygiene assistance, and agricultural and life skills training to hundreds of Cambodian children annually. He also offers humanitarian service trips there regularly. His stateside non-profit, Khmer Child Foundation, serves this initiative. David lives with his husband Ty Andrews in Atlanta, Georgia.


Cara Silletto, MBA, is the founder and president of Crescendo Strategies, an HR firm working with clients across the country to reduce unnecessary employee turnover and the costs associated with it. Crescendo's specialties include bridging generational gaps, making managers more effective in their roles, ensuring knowledge is successfully transferred from seasoned professionals as they retire, and validating the root causes when great talent is walking out the door.


Cara is an early millennial (she was born in 1981), only a couple of years late for Generation X. As such, Cara was born in a "sweet spot" for her specialty of bridging generational divides, and now she has more than a decade of professional experience applying that knowledge. Cara knows the unwritten expectations of older managers and business owners, but she also understands firsthand why 70% of young professionals are fearlessly leaving their jobs in less than two years, and each lost employee can cost a company thousands of dollars (sometimes hundreds of thousands for highly specialized positions). Cara will quantify the true problems clients face and provide the strategic perspective needed to keep the best talent.


Click HERE for Exhibitor Prospectus


Click HERE for Attendee Pre-Registration Form



Value First


Save Money on MRO Looking for savings on maintenance, repair and operations? Whether you are in the market for new appliances and air conditioning units, or planning to replace flooring and furniture, let Value 1st vendors compete for your business.


Many Value 1st vendors are industry leaders your community may already do business with.


Reduce Ongoing Renovations Expense
If your community does a significant number of unit upgrades or renovations throughout the year, Value 1st can work with vendors to get pre-negotiated prices on appliances and other items based on anticipated volume for the year. You achieve savings on pricing based on total quantity, rather than one-off discounts. And, items can be drop-shipped as needed so you don't have to worry about storage space.


Value 1st members are eligible to have cost studies done free of charge.

  • Food and Dietary Services
  • Janitorial and Housekeeping
  • Medical Supplies
  • Office Supplies

Cost studies help to identify potential savings by comparing what you are currently paying vs. Value 1st GPO contract prices.


Contact your Value 1st Representative
Georgia ▪ North Carolina ▪ South Carolina
For additional information contact your Value 1st representative Vanessa Ceasar at (404)421-3956 or

Free Cost Studies on Recurring Expenses



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New Members

Grace Arbor
Robin Dill
P.O. Box 2127
Lawrenceville, GA 30046
Adult Day Services


Assured Partners
Drew Mood
501 Hager Street
Columbia, SC 24201

Continuum CRM
Kristin Hambleton
6340 Sugarloaf Parkway, Suite 200
Duluth, GA 30097


Mindful Transitions

Laura Jalbert

P.O. Box 862127
Marietta, GA 30062



Royal Flush Plumbing, Inc.
Tim Winterstein
4276 Sonte Mountain Highway
Lilburn, GA 30047


Summer Classics Contract
Mark Rodell
3140 Pelham Pkwy, Suite 300
Pelham, AL 35124
Commercial Outdoor Furniture




Calendar Information


To assist with planning, we are sharing information on special holidays and observances for each month 2 months early.


This month we are sending you information for April






April 1 April Fool's Day

April 9 Palm Sunday

April 11 Passover Begins

April 14 Good Friday

April 16 Easter

April 22 Earth Day

April 26 Adminitrative Professionals Day

April 28 Arbor Day





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Public Policy


LeadingAge Georgia Public Policy Report

By Tom Bauer, LeadingAge Georgia Policy Advisor


The 2017 Georgia General Assembly began Monday January 9 and, as of February 1, was a little more than 25% of the way through its 40 legislative days. Except for budget hearings the pace has been very slow; however, legislation is now starting to be considered in committees. All indications point to a fast session, currently slated to conclude on March 30.


Adult Day Services

As noted last month, LeadingAge Georgia will also be attempting to seek another increase in 2017 in order to begin to bring Adult Day Health (ADH) reimbursements up to a more appropriate level. However since Georgia is still awaiting federal approval of the 5% increase in Medicaid reimbursement for adult day health service rates passed in 2016, it may be more difficult to obtain another 5% increase.


One bit of hopeful news is that the reimbursement rate increase for the "COMP "waiver has just been approved by CMS. Hopefully this means that the ADH reimbursement increases will follow suit soon.



The FY '18 state budget recommendations from Governor Deal contain good news for seniors. The governor has included new funds to help older adults and those with disabilities remain in the community as follows:

  • $2.755 million for Medicaid Community Care Services Program (CCSP)
  • $4.2 million for non-Medicaid home and community-based services (HCBS)
  • $750,000 for congregate meals

Proxy Caregivers

The House Committee on Human Relations and Aging recently heard extensive testimony from providers to the effect that the training required of proxy caregivers has become burdensome in as much as it is required with great frequency and specificity to each patient. The General Assembly passed the proxy caregiver law a few years ago to allow persons who are not licensed to provide healthcare services to be trained to assist persons with disabilities with certain "health maintenance activities" in odder that such person could remain in the community rather than be institutionalized. LeadingAge President Walter Coffey was as member of the original task force which developed the proxy caregiver concept. Representative Tommy Benton chair of the Committee, is encouraging both the Departments of Community Health and ad Behavioral Health and Developmental Disabilities to find ways to address the issue.


2016 Federal Wrap-up and a Look Forward to the New Year With Congress gaveling into session earlier this week and President-elect Donald Trump set to be inaugurated on January 20, the advocacy staff at LeadingAge national have prepared an excellent summary of action in 2016 and a look ahead at what to expect in the New Year.


Call-In Days Regarding Medicare

Thanks to LeadingAge Georgia members who made calls to members of Congress requesting no change in the current Medicaid structure!

Georgia Institute on Aging







2017 Professional Developments in Full Swing

Elderly Housing Symposium at Decatur Christian Towers


HUD Regional Director and Regulators


Alisha Sanders, LeadingAge Center for Applied Research


Financial Preparedness Symposium




Professional Development Committee Meeting & Phone-a-Thon



Upcoming Events



Leadership Academy First Event
February 15, 2017

Power of Purpose: Workforce Summit

February 16, 2017



Activity Professionals Forum Conference Call

February 22, 217


Service Coordinator Forum Conference Call

February 22, 2017


Maintenance Professionals Forum Meeting

Briarcliff Oaks

February 22, 2017


Adult Day Services Symposium

February 24, 2017



March Assisted Living Symposium

March 2, 2017

Registration coming soon

Certified Eden at Home Certification
March 7-9, 2017

Registration coming soon

Leadership Academy Second Event

March 15, 2017

LeadingAge PEAK Leadership/Advocacy Conference in Washington, DC

March 20-22, 2017

2017 Annual Conference: Power of PURPOSE

Hilton Head Island, SC

March 27-29, 2017

Exhibitor Prospectus

Attendee Pre-Registration Form


AprilSupervisor & Manager Leadership Summit
(includes budgeting 101, conflict resolution, coaching)

April 20, 2017


Mental Health First Aid with Older Adult Module

April 27, 2017



CCRC Symposium

May 5, 2017


Leadeship Academy Third Event

May 17, 2017


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Center for Positive Aging






Who Will Care for the Caregivers? I should have put his socks back on.
The thought kept nagging me as I finished my clinic notes, replaying the afternoon in my head. My final patient of the day — a man with dementia — was a late addition to the schedule, after his daughter, herself a patient of mine, called to report he hadn't been
himself lately. We scheduled him for the last appointment, so she could join after finishing work across town.

Full Article




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Culture Change News







Easing Older Adult's Loneliness Can Help Keep Them Healthy Emil Girardi moved to San Francisco on New Year's Eve in 1960. He loved everything about the city: the energy, the people and the hills. And, of course, the bars, where Girardi mixed drinks for most of his adult life. About 10 years ago, the 83-year-old New York native had a stroke and collapsed on the sidewalk near his Nob Hill home. Everything changed. "I didn't want to go out of the house," Girardi recalled, adding he only felt comfortable "going from the bedroom to the dining room." He'd started to fear the city's streets — and growing older.


Full Article



Creating and Sustaining the Balance Between the Up-side and the Down-side Risk of LIVING Ray Miller, MSOSH, Director of Risk & Safety Solutions, Direct Supply


When we think of "risk," particularly in the healthcare setting, we often think of the "fire" or the "fall" -- the "downside risk." And while I am not advocating that we ignore such untoward and undesired events, I am advocating for a broader and perhaps even "choice-empowering" view.


The view to which I refer is the view of creating the balance between Person-centered care/person-directed care and the resulting upside and down-side risks.


First, an example: I have a friend, well-respected, wise and caring, that has ENABLED Residents on oxygen to go camping. In another instance, she EMPOWERED Residents to go for a flight in a hot air balloon. To both of those, some might say "TOO RISKY." I feel now, and I felt at the time she taught me, "That is a Community that I could see myself living in (someday, though not just yet)."


In both cases we might ask but why? Why the risk? Why the bother? Why? Because they never had, yet always wanted to. HOW did her care team accomplish it you ask? By seeking and adhering to that balance.


For another way to think of "risk," I'll use the name "Peter." Peter taught us this: "Don't get me wrong, carers (care givers) are the most important people in the world; but you can have "carers," and you can have 'keepers.' The keepers try to AND assume total responsibility for your life, prematurely".[i]


Might I say, "OUCH".


So what if we consider "risk" from a slightly different perspective? Another friend of mine, again a well-respected, wise and caring person taught me this as said by the visionary Maria Montessori, "That which you do FOR me, you take FROM me." Not immediately, and perhaps not even intentionally, but nonetheless IF you repeatedly, consistently, and I would add, UNWISELY and PREMATURELY, "keep me," "prevent me" or "protect me" from doing things -- normal things, daily life things - THEN I will lose the ability to do those things at all.


Which areas of ability will I lose? Physical, mental, emotional, muscle memory, desire, all of these and others are the abilities that will begin to decline, to diminish, to decay.


Really? You want to put me in a wheelchair? I get it, I walk slowly. I've gotten to the point that I struggle to make it the whole way to the dining room. But please DON'T put me in your stinking (yes, a swear word) wheelchair. Why? Because, at least I can still walk!


"But we've always done it that way!" Here are a couple of responses to that habitual retort:


NOT everyone does it that way or thinks that way.

  1. The 2012 Life Safety Code provides an alternative (and by-the-way, THREE Cheers for Pioneer Network!!) You can now, following the clearly-outlined requirements, have "furniture clusters" (my expression) in your hallways where residents can rest, visit and hold onto the dignity of WALKING.
  2. There is a balance that CAN and MUST be achieved between the downside risk and the upside risk of LIVING.

As Henry Ford taught us: "Coming together is a beginning; staying together is progress; and working together is success." So I invite you to give this more thought, and continue the conversation with your family, your co-workers, your residents.



1st Annual North American Dementia Education Conference



Click here to learn more



Sponsored by:



Culture Change Network of Georgia Advisory Group Meeting

CCNG advisory group 2017 meetings
April 28 at the Atlanta Regional Commission
August 11 at the Alzheimer's Association
October 27 at Lenbrook in Buckhead


Watch for information and materials.




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Adult Day Services News (GADSA)



Adult Day Services Symposium - Save the Date

The 2017 Adult Day Services Symposium will be held February 24, 2017 at Trinity Presbyterian Church in Atlanta. Information and registration coming soon.


2017 GADSA Leadership Team

President: Claire Russell, The Homeplace

Vice-Presidents Public Policy: Ned Morgens, Skylark Senior Care; Aysha Cooper, SarahCare of Snellville

Vice-Presidents of Members: Georgia Gunter, Adult Day of Dunwoody; Carla Jones, Rosswoods

GA Association of Activity Professionals










GAAP Chat/Forum

February 22, 2017 - 9:00am

Dial 712-432-6100

Passcode: 27514617


2017 GAAP Leadership Team

President: Wendy Boyd (The Gardens at Calvary; Columbus)
Vice-President: Laura Jones (Briarcliff Oaks; Atlanta)
Membership: Kathy Hobbs (Canterbury Court; Atlanta)
Program/Education: Scott Bassett (Philips Tower; Decatur)

LeadingAge Georgia Business Connection

Metz currently has more than 160 food service and environmental service accounts in 14 states. Our dining management and environmental services put customers and their guests first. Unlike other foodservice management companies, we are a step ahead of dining and nutrition trends. We constantly adapt our operations, menus, environments and marketing strategies to meet the needs of your guests as well as your organization. Our restaurant-centric approach isn't an accident. We get first-hand knowledge from the franchise brands we operate around the mid-Atlantic region including T.G.I. Friday's, Ruth's Chris Steakhouse, Wolfgang Puck Express and Krispy Kreme. You can expect expertly-made food with the freshest produce, meats and high-quality ingredients when you choose us to assist with dining management. Or, let us help you keep your facilities and property clean, green and attractive with our environmental services. No matter the need, our family-owned and operated business delivers outstanding service adapted for your community and workplace. Let us offer that extra-personal touch.


Environmental Services includes keeping your facilities and property clean, green, and attractive. Designed to keep your facilities looking top-notch, Metz's environmental services include housekeeping, linen and laundry and interior and grounds maintenance.


Main Contact:

Jack Brill
Metz Culinary Management
Phone: 941-554-4701

Metz Culinary Management is making a concerted effort to expand in the South with the hiring of Jack Brill as Vice President of Business Development for the company's Southern accounts, which include clients in healthcare, long term care, colleges, universities and independent schools. Brill has more than 25 years of progressive experience in the retail and foodservice industry. He has worked with multinational food corporations, independently owned family-run operations and military programs in addition to owning and operating two foodservice companies. Past responsibilities also include national sales management, sales force training and distributor program selling.

News Throughout the Spectrum of Aging Services

Assisted Living Communities/Personal Care Homes

How Baby Boomers Are Redefining Assisted Living
According to a recent Nielsen marketing report, in less than five years 50% of the U.S. population will be over the age of 50, controlling 70% of the nation's disposable income and poised to inherit $15 trillion over the next 20 years.


The baby boomer generation is clearly in the driver's seat — and the result is that the assisted and senior living industry is quickly adapting to meet the needs of a generation that won't settle for anything less than the best. Learn more about how baby boomers are redefining assisted living as we know it.

Baby Boomers Are Redefining Assisted Living
Firmly in control and able to pay for the care and services they deserve, baby boomers are redefining assisted living. Unlike the generations before them, baby boomers won't be moving to senior living communities out of medical necessity. Instead, lifestyle choices will be the driving force behind their decisions.


The shift from medical services to lifestyle offerings has had a huge impact on all areas of assisted living.

Here's how the industry is shifting to meet the needs of the affluent baby boomer generation:

Boomers Require Age-Sensitive Language
The senior living industry is overhauling the language they're using to market to baby boomers, who "don't want to be reminded of their age, but of their accomplishments and of their future," Steve Olenski, a contributor to Forbes points out, suggesting marketers should concentrate on the bucket list concept when pitching to baby boomers.

"If you think 'aged,' 'elderly' and 'senior' are effective buzzwords for baby boomers – think again." Olenski says.


The industry is responding to this language overhaul. For example, the term continuing care retirement communities (CCRC) is being replaced with the term "life plan communities." "The change, it is hoped, will improve the overall perception and speak to the current needs of today's seniors," suggests Ben Mandelbaum, chief operating officer of LTC Consulting Services and Senior Planning Services.

Baby Boomers Expect Customized Amenities in Assisted Living
As the most affluent generation ever, baby boomers are used to customized consumerism – the one size fits all approach doesn't compute with this demographic. As a result, assisted living communities are offering a greater variety of amenities and programs that appeal to different lifestyles and accommodate a wider range of interests. The result is that most retirement communities offer a variety of options for hobbies that coincide with baby boomer's needs.


These changes go beyond increased options for social activities. Baby boomers have been lobbying for improved care and privacy across the senior living industry. Many assisted living and retirement communities have responded by offering increased responsiveness from medical staff who are more specialized than ever before.


Senior living communities across the country are also offering baby boomers access to specialized medical staff including counselors, massage therapists, physiotherapists and psychiatrists. Other personalized staff on site at these communities include trained geriatric care managers, gourmet chefs, nutritionists and personal trainers.

How Assisted Living and Nursing Care Play an Important Role
Although they're taking a back seat in the marketing strategy of most senior living communities, assisted living and nursing care are still an important offer to baby boomers – if and when needed.

Baby boomers expect access to the medical and nursing support that they will inevitably need, however the expectation is that these services will be a basic offer available across the board no matter where they go.


The value-added elements that will help baby boomers choose one community over the next is more likely to involve the activities, amenities, independence and privacy offered. With financial independence and an array of options to choose from, baby boomers are successfully redefining the senior living industry as they refuse to change their expectations or the lifestyle they have for their retirement years.


Survey Finds Assisted Living Residents Are Satisfied
The survey commissioned by the Assisted Living Federation of America found that assisted living residents are overwhelmingly satisfied with their lives at assisted living.

• 86% of residents feel that staff "care about me as a person."
• 87% of residents feel staff are qualified and well trained.
• 94% are satisfied with their overall quality of life.
• 93% are satisfied with the level of independence afforded by the community.
• 90% are satisfied with the quality of care they receive.
• 93% are satisfied with the amount of attention they receive from staff.

How Assisted Living Provides the Highest Quality of Care
These overwhelmingly positive results are very much in line with internal satisfaction surveys of assisted living residents conducted by the government and major national provider-commissioned surveys.


Major assisted living providers frequently survey their residents, and their businesses depend on accurate results. That is the primary purpose of these surveys. If residents become unhappy about some aspect of their life at a particular provider's community, they will take their business elsewhere. It's only after scrutinizing the results for internal insights that they are used for publicity by providers.


Even more convincingly, government sanctioned surveys of assisted living residents find satisfaction levels above 90%. For instance, the Ohio Department of Aging annually surveys residents at assisted living communities and recently found that the satisfaction level for assisted living residents in the state is 91.7%, which is similar to ALFA's findings.


2017 Assisted Living Symosium

Save the Date - March 3, 2017

Details coming soon.

Federally Assisted Housing (HUD-Subsidized)

Trump Administration's Proposed Spending Cuts Threaten Affordable Housing, Group Says
Assessing the comments Ben Carson, M.D., made Thursday during his confirmation hearing for the role of secretary of the U.S. Department of Housing and Urban Development, National Low Income Housing Coalition President and CEO Diane Yentel said that she was encouraged by his seemingly newfound appreciation for HUD programs but not by his reiteration of President-elect Donald Trump's commitment to cut nondefense discretionary spending by 1% annually.

Full Article


Pooling Resources to Serve Housing Residents
A new case study from the LeadingAge Center for Housing Plus Services explores how a team of physical health, mental health, and social work professionals is collaborating with property-based resident service coordinators to provide onsite assistance to 1,400 older adults living in 11 affordable housing communities in Portland, OR. The Housing with Services (HWS) program was initiated by Cedar Sinai Park, a LeadingAge member in Portland, after a resident assessment revealed that a highly vulnerable population of older adult lived in 4 of the organization's affordable senior housing properties. Residents had high levels of physical and mental health problems and significant challenges related to social determinants of health, including access to nutritional food. These issues put the population at high risk for excessive or inappropriate use of emergency rooms and hospitals, as well as movement to nursing homes, according to the case study.

Full Article


HUD Announces Awards for Supportive Services Demonstration Grants
In a press release issued January 13, HUD announces $15 million in awards to test a new approach to help low-income seniors age in place. With these new grants, HUD will cover costs related to hiring a full-time Enhanced Service Coordinator and a part-time Wellness Nurse to connect the elderly with the supportive services they need to maintain independent living and age-in-place. The goal here is to help delay or avoid the need for nursing home care.


Full Article



Home and Community Based Services

HCBS-01-17-01 Participant Contact Letter Update
The Home and Community Based Services (HCBS) Manual has been revised to include updates to Policy 4.00 Appendix 11 Participant Contact Letter and Instructions and Appendix 12 Participant Communication – Reason for Contact. These documents are new to the policy and must be utilized in all instances of contact with a participant by means of a letter. The Participant Communication – Reason for Contact replaces the previous Appendix 12, which has been incorporated into Appendix 11 and has been created to simply the process in selecting an appropriate reason for contact.

Please refer to the memorandum and policy at the links provided below.





Any questions should be directed to the Bureau of Long Term Services and Supports at or 573.526.8557.


U.S. Attorney: Common Home Health Schemes 'Turn System Upside Down' Home health care agency owners would be the first to say the industry is seeing an onslaught of new regulations. However, there may be good reason for it—the industry is rife with improper and fraudulent payments, according to the Centers for Medicare & Medicaid Services (CMS). A whopping 59% of home health payments in 2015 were improper, according to CMS. By comparison, the overall fee-for-service (FFS) improper payment rate was 12.09% in 2015 and 11% in 2016, CMS told Home Health Care News. Errors and poor training contribute heavily, but the Medicare system has several vulnerabilities that enable high rates of fraud and abuse, as well.

Full Article


GAO: Medicaid's Approach to Home Care Needs More Uniformity

Medicaid currently pays for personal care services through a patchwork of different waivers and other programs, with varying standards for ensuring that beneficiaries are kept safe and billing is above-board. This needs to change, according to a newly released report from the federal Government Accountability Office (GAO). To compile its report, the GAO evaluated Medicaid-funded personal care in California, Maryland, Oregon, and Texas.

Full Article


CMS Issues Final Rule to Modernize Home Health Conditions of Participation

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule outlining the Medicare and Medicaid Conditions of Participation (CoP) for home health agencies. Prior to the new finalized rule published Monday, the CoPs had not been updated in roughly two decades, when many of the requirements were first created. The new rule was long-expected after a draft proposal was introduced in late 2014. The rule needed to be finalized within a three-year window and will be published on the Federal Register on January 13, 2017.


Full Article


Home Health Sector Faces Short Deadline for Sweeping New Rule

The home health industry is about to be inundated with new regulations after a long-expected update of the Conditions of Participation (CoP) was released by the Centers for Medicare & Medicaid Services (CMS) Monday. With the introduction of the final rule that defines what is needed to participate in the Medicare and Medicaid programs, home health agencies and industry groups are wading through numerous changes. With an effective date of July 13, 2017, agencies have roughly six months to comply. One area of concern is the implementation time, which is much shorter than what was requested by agencies and home health associations during the comment period.

Full Article


How Home Care Agencies Can Better Support Latino Caregivers
There has been an ever-increasing focus on recruitment and retention efforts for home care workers amid high turnover rates, the Fight for $15 movement and competition from other sectors. Given the diversity of today's workforce, even more attention must be paid to specific populations, namely Latinos and immigrants, if home care agencies want to adequately provide for their staffs.

Full Article


CMS Issues Final Rule on Home Health Agency Conditions of Participation
On January 13, CMS published a final rule updating the Medicare and Medicaid conditions of participation for home health agencies (HHAs). The rule requires a series of changes, such as:

  • A comprehensive patient rights condition of participation that clearly enumerates the rights of home health agency patients and the steps that must be taken to assure those rights.
  • An expanded comprehensive patient assessment requirement.
  • A requirement that assures that patients and caregivers have written information about upcoming visits, medication instructions, treatments administered, instructions for care that the patient and caregivers perform, and the name and contact information of a home health agency clinical manager.
  • A requirement for an integrated communication system that ensures that patient needs are identified and addressed, care is coordinated among all disciplines, and that there is active communication between the home health agency and the patient's physician(s).
  • A requirement for a data-driven, agency-wide quality assessment and performance improvement (QAPI) program.
  • A new infection prevention and control requirement that focuses on the use of standard infection control practices.
  • A streamlined skilled professional services requirement that focuses on appropriate patient care activities and supervision across all disciplines.
  • An expanded patient care coordination requirement that makes a licensed clinician responsible for all patient care services.
  • Revisions to simplify the organizational structure of home health agencies while continuing to allow parent agencies and their branches.
  • New personnel qualifications for home health agency administrators and clinical managers.

Read the final rule here.


Top 3 CoP Changes to Impact Home Health Agencies
The newly finalized home health conditions of participation (CoPs) will have wide implications for agencies, but not all the changes are new or likely to be costly. The CoPs, which were updated after nearly three decades in a final rule issued in early January, aim to improve the quality of health care services for home health patients and strengthen patient rights, according to the Centers for Medicare & Medicaid Services (CMS). The changes are coming with a high cost—up to $234 million in annual costs, according to CMS, with a short timeline for almost all the new regulations, which will go into effect July 13, 2017. That comes out to about $30,000 per agency, according to the National Association for Home Care & Hospice (NAHC), which recently held a webinar to discuss the impact of the new provisions.


Full Article


Life Plan Community (CCRC)

Keys to repositioning your Life Plan Community/CCRC
When a continuing care retirement community is experiencing success, it can be tempting to "go with the flow" and stick with existing operations, plans and programs. We know that ensuring continuing success — in fact, just remaining viable — requires a different mindset, however. One that is focused on smart repositioning. Even if our current customers are happy and might actually resist changes to their homes, we must prepare to meet the expectations of future residents. The next generation of future residents is coming, and with it, our next revenue stream. How can we ensure that we are ready?

At Applewood, a 25-year-old central New Jersey CCRC, we launched a master-planning process that emphasized input from all stakeholders, not just the CEO or director at a strategic planning meeting. We especially sought the perspective of residents — both current and future (we used our waiting list). Current residents can tell you better than anyone else what your community may need. Future residents are shopping for communities that meet their needs and desires; having insight to their "shopping list" is invaluable.


Full Article


Ziegler shares insights into large-campus CCRCs
Many large-campus continuing care retirement / life plan communities — those with at least 500 independent living units on the same campus — already have been built out through expansions over the years. Several communities, however, will continue to expand on existing or adjacent land to increase their total number of units, according to Lisa McCracken, senior vice president of senior living research and development for Ziegler, writing in the investment bank's April 25 Z-News newsletter.

"A number of providers have scaled back the size of their new developments and are building out in phases," she said. "Even the newest Erickson Community, Lantern Hill in New Jersey, is a smaller-scale community compared to its existing portfolio."

Two large, for-profit communities are in the planning stages, both with more than 800 total units, McCracken said. Cresswind Charlotte in North Carolina and Peachtree Hills Place in Atlanta both plan to offer 55+ housing, independent living and skilled nursing.
Large-campus CCRCs "are few in number but clearly significant in impact," she said. Campuses range from 50 to more than 2,000 acres and benefit from scale, growth opportunities and self-sufficiency.

The large campuses are prominent in the same metropolitan statistical areas in which CCRCs in general are located, McCracken said. Eighty-one of such properties are located in the largest 30 MSAs. Philadelphia tops the list, with 10 large campuses, and Chicago comes in second place, with seven.

Other characteristics of large-campus CCRCs, according to the article:

  • Almost 85% are sponsored by not-for-profit organizations, and almost 50% are sponsored by a faith-based organization.Sixty-five percent are part of a multi-site organization.
  • National Senior Campuses, managed by Erickson Living, and Brookdale Senior Living have the largest number of large-campus communities.
  • About 85% of the communities have entry fee contracts as opposed to being rental CCRCs.

2017 CCRC Symposium

Save the Date - May 5, 2017

Details coming soon.


Nursing Care/Rehab

LeadingAge, Advocacy Groups Call on Trump to Preserve Nursing Home-Related ACA Provisions
LeadingAge joined 71 other non-profit aging organizations this week in urging President-elect Donald Trump to retain nursing home quality standards within the Affordable Care Act. Trump has urged Congress to "repeal and replace" the law. In the Leadership Council of Aging Organizations' Jan. 10 letter the groups, including LeadingAge and the Center for Medicare Advocacy, highlight 12 aging-related provisions of the ACA that "have broad support and should remain intact."

Full Article


New Nursing Home Rules Offer Residents More Control of Their Care

About 1.4 million residents of nursing homes across the country now can be more involved in their care under the most wide-ranging revision of federal rules for such facilities in 25 years. The changes reflect a shift toward more "person-centered care," including requirements for speedy care plans, more flexibility and variety in meals and snacks, greater review of a person's drug regimen, better security, improved grievance procedures and scrutiny of involuntary discharges. "With proper implementation and enforcement, this could really transform a resident's experience of a nursing home," said Robyn Grant, director of public policy and advocacy for the Consumer Voice, a national group that advocates for residents' rights.

Full Article


CMS Reports 'Sharp' Drop in Avoidable Hospitalizations Among Long-Term Care Residents
The rate of potentially avoidable hospitalizations among dual-eligible long-term care residents fell by nearly a third in recent years, the Centers for Medicare & Medicaid Services reported on January 17th. In a data brief posted on the CMS blog, officials
documented the "real progress" made in reducing cases of potentially preventable hospitalizations among long-term care residents over the last decade. Overall, the hospitalization rate for beneficiaries eligible for both Medicare and Medicaid — including those outside of long-term care facilities — fell 13% between 2010 and 2015.


Full Article

General Notes of Interest

CMS Releases Community First Choice Guidance Package On December 30, the Centers for Medicare and Medicaid Services (CMS) published a State Medicaid Director letter (SMD) providing guidance on the 1915(k) Community First Choice (CFC) state plan option. CFC allows states to amend their state plans to provide home and community-based attendant services and related supports without the use of a waiver and independent of the type, nature, or severity of an individual's disability. CFC services receive an enhanced FMAP of six percentage points above the state's regular FMAP.


The SMD is available here and the SPA pre-print and technical assistance resources are available on CMS's website here.

CMS Guidance on Residents Who Wander CMS released a very important "Frequently Asked Questions" notice concerning Medicaid Beneficiaries in Home and Community-Based Settings who Exhibit Unsafe Wandering or Exit-Seeking Behavior on December 15, 2016. State officials, adult day and assisted living providers, beneficiaries and other stakeholders have concerns on how to adhere to the HCBS settings rule in relation to service provision for individuals with dementia or other conditions in which unsafe wandering or exit-seeking behavior is exhibited.


Meals on Wheels Wants to Be The 'Eyes and Ears' for Hospitals, Doctors Debbie Case held an insulated bag with two packaged meals — a sandwich wrap and fruit for lunch, a burrito and cauliflower for dinner. "You're going to eat well today," Case told 75-year-old Dave Kelly as she handed him the meals. Kelly lost his sight about two years ago and reluctantly gave up cooking. After putting the food away, Kelly chatted with Case about his experience as a folk musician. As they talked in his living room, Case, CEO of San Diego County's Meals on Wheels program, glanced around for hazards that could cause Kelly to fall.

Full Article


Provider Sees Onsite Daycare as Worker Retainment Tool Can an onsite daycare center help attract and keep workers at a senior living community in a competitive market? Ecumen Detroit Lakes in Minnesota thinks so and is seeking a $50,000 grant from the LeadingAge Minnesota Foundation to help its plans become a reality, according to Detroit Lakes Online. If the funding is approved, the center would be located in a currently "underutilized area" of the campus that would be renovated to meet daycare regulations, according to the website.

Full Article


Caregiver Shortages Could be Addressed by Worker-Owned Cooperatives, Researchers Say Worker-owned cooperatives could offer a solution to caregiver shortages in aging services, according to a recent case study published in Affilia: Journal of Women and Social Work. University of Georgia Assistant Professor Rebecca Matthew, MPH, MSW, Ph.D., and Vanessa Bransburg, MSW, a cooperative development specialist, examined the most popular forms of paid child care — for-profit and nonprofit services — alongside worker-owned child care cooperatives. They found that cooperatives, which give employees greater control over their working conditions and a share in profits, improved the quality of life of both care recipients and providers.

Full Article


LeadingAge Quality Scorecard LeadingAge national has released the first version of the LeadingAge Quality Score Card. This tool was developed by the Public Policy Congress and the LeadingAge Quality and Risk Management Advisory Council. It basically lists various quality measures that nursing homes, home health agencies, adult day centers, assisted living residences, and senior housing providers can use for internal quality improvement efforts as well as to market to other payers and providers in the health care arena.


National Association of State Medicaid Directors Responds to HCBS Request for Information On January 9, NAMD submitted a response to a CMS Request for Information (RFI) on the future of Medicaid home and community-based services (HCBS). In the RFI, NAMD calls for CMS to reassess the federal-state partnership in HCBS program administration and provide more predictable, streamlined oversight and approval processes that prioritize positive beneficiary outcomes. Additionally, NAMD notes that the HCBS landscape is undergoing significant change, in part driven by CMS's HCBS settings rule, and this evolution must be carefully considered in any future rulemaking. In responding to the RFI's specific questions, NAMD recommends CMS consider additional flexibilities under waiver authorities, including 1115 demonstration waivers and 1915(c) HCBS waivers, to support targeted programs aimed at further rebalancing Medicaid long-term services and supports (LTSS) towards the community. NAMD expresses concern with additional federal rules or requirements around provider conditions of participation, mandatory reporting requirements across all state HCBS programs, or other measures that are not sensitive to the specific, highly variable structures of state HCBS programs. Additionally, NAMD cautions against more stringent federal approval processes for HCBS rates.

Read the full comments here.


A Housing Crisis for Seniors Last fall, I had to take the car keys away from an elderly relative who lives alone. This intervention should have happened much earlier, but when the day came it was one of the more emotionally wrenching things I've ever done. "Don't take my car away," he pleaded. "Without my car I don't have a life." The fear he expressed is one shared by many older Americans, who, overwhelmingly, live in places where car travel is a necessity.


Full Article


Improving Guardianship Systems is Aim of Demonstration Project A new demonstration project has the goal of improving state guardianship systems for older adults with dementia, individuals with disabilities and others. The pilot project, which will be funded by Elder Justice Innovation Grants from the U.S. Department of Health and Human Services' Administration on Community Living, will be conducted by the American Bar Association Commission on Law and Aging and the National Center for State Courts. Other aims of the work will be to avoid unnecessary guardianship and to prevent and address abuse.

Full Article

Toddlers and Seniors Live, Eat and Play Together at Intergenerational Home Joe Ryan left the Bucktown apartment that he shared with four roommates in July for a studio apartment that was not only miles away, but also a living experience that couldn't be more different. Ryan, 26, moved into a "intergenerational living facility" that is overwhelmingly home to senior citizens in Rogers Park. He rents the apartment at Nathalie Salmon House at 7320 N. Sheridan Road at a reduced rate in exchange for helping part-time as a live-in resident assistant at the facility.

Full Article


Trump's Health Plan Would Convert Medicaid to Block Grants, Aide Says
President Trump's plan to replace the Affordable Care Act will propose giving each state a fixed amount of federal money in the form of a block grant to provide health care to low-income people on Medicaid, a top adviser to Mr. Trump said in an interview broadcast on January 22nd. The adviser, Kellyanne Conway, who is Mr. Trump's White House counselor, said that converting Medicaid to a block grant would ensure that "those who are closest to the people in need will be administering" the program.

Full Article

Everything You Need to Know About Block Grants — The Heart of GOP's Medicaid Plans

President Donald Trump's administration made explicit this weekend its commitment to an old GOP strategy for managing Medicaid, the federal-state insurance plan that covers low-income people — turning control of the program to states and capping what the federal government spends on it each year. It's called "block granting." Right now, Medicaid, which was expanded under the 2010 health law to insure more people, covers almost 75 million adults and children. Because it is an entitlement, everyone who qualifies is guaranteed coverage and states and the federal government combine funds to cover the costs. Conservatives have long argued the program would be more efficient if states got a lump sum from the federal government and then managed the program as they saw fit. But others say that would mean less funding for the program —eventually translating into greater challenges in getting care for low-income people.

Full Article





Tablet Computers Help Manage Agitation in People with Dementia: Study Tablet computers are safe and potentially effective in managing agitation among people with dementia, according to the results of a small pilot study in press by the American Journal of Geriatric Psychiatry. "Our preliminary results are a first step in developing much-needed empirical data for clinicians and caregivers on how to use technology such as tablets as tools to enhance care and also for app developers working to serve the technologic needs of this population," said Ipsit Vahia, M.D., lead author of the study and medical director of geriatric psychiatry outpatient services at McLean Hospital in Belmont, MA.


Full Article


CMS Stresses Disaster Preparedness in Cyber Security Advisory Long-term care providers should consider cyber security when developing and reviewing their emergency-preparedness plans, the Centers for Medicare & Medicaid Services advised in a memo sent January 13. The notice, shared with state survey agency directors, acknowledged that while the agency's recently released emergency preparedness rule did not specifically address cyber security, providers could still benefit from adopting an "all-hazards approach" to mitigating cyber attacks. The "all-hazards" approach focuses on the capabilities necessary for providers to be ready "for a full spectrum of emergencies or disasters," CMS said.

Full Article



Job Mart

Activity Director - Calvin Court

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Financial Director - Athens Community Council on Aging

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